Supreme Court to review key Biosimilar Dispute between drugmakers Amgen and Novartis’ Sandoz unit over the process for launching a biosimilar version of a branded biologic

Reporter: Aviva Lev-Ari, PhD, RN

Dive Brief:

The Supreme Court last week agreed to review a dispute between drugmakers Amgen and Novartis’ Sandoz unit over the process for launching a biosimilar version of a branded biologic, setting the stage for an important ruling later this year.

At issue are key provisions of the Biologics Price Competition and Innovation Act (BPCIA) which govern when a biosimilar developer needs to give notice to branded drugmakers of its intent to sell a biosimilar, which are highly similar, copycat versions of pricey biologic drugs.

While the legal details are technical, the case will set an important precedent for the emerging field and could clarify how biosimilars are brought to market.

The case also involves whether biosimilar drugmakers are required to disclose a copy of a biosimilar application and information about its manufacturing processes to the branded drugmaker — a process known as the “patent dance.”

Federal appeals court reaffirms biosimilar launch rules

Dive Brief:

A federal appeals court reaffirmed on Tuesday that biosimilar drugmakers are required to notify brand-name companies of their intent to sell a copy biologic six months before marketing the drug.

Canadian drugmaker Apotex, which has applied for U.S. approval for a biosimilar version of Amgen’s Neulasta, tried to argue it did not need to provide Amgen with notice of commercial marketing as it had already provided Amgen with manufacturing and patent information.

The same court previously ruled in a related case pitting Amgen against Novartis’ Sandoz unit, saying biosimilar drugmakers must wait until after receiving approval from the Food and Drug Administration before submitting their marketing notice.

Dive Insight:

Under the Biologics Price Competition and Innovation Act (BPCIA), a biosimilar manufacturer must provide brand-name drugmakers with 180-day notice before selling a copy biologic. Biosimilar makers such as Apotex and Sandoz want to be able to submit this notice 180 days before the FDA decides on approval, thereby enabling them to begin selling immediately after receiving a license.

While the issue at stake may appear a minor technicality, the rulings could set a broader precedent for the growing biosimilar market in the U.S.

In the earlier Amgen v. Sandoz case, the U.S. Court of Appeals for the Federal Circuit sided with Amgen and ruled Sandoz (and other biosimilar companies) must wait until after FDA approval, essentially granting brand-name drugmakers a de-facto six-month extension of market exclusivity.

Biologic drugmakers already have 12 years of market exclusivity and an extra six months would give them more time to prepare legal challenges to a new entrant, not to mention adding another half-years’ worth of protected sales.

Sandoz appealed the decision and the Supreme Court is now considering whether to hear that case

With Tuesday’s ruling in Amgen v. Apotex, the appeals court affirmed its previous ruling and further stipulated that providing notice commercial marketing is mandatory regardless of whether a biosimilar company has submitted manufacturing and patent information in the so-called “patent dance” under the BPCIA.

Apotex unsuccessfully argued it did not need to submit the 180-day notice because it had already informed Amgen by exchanging patent information.

DPCIA – Congress required exchange of Inforamtion , Upon FDA Approval, no problems of IP Reference Product Sponsor – identify all Patents composition, Methods of Manufacturing, Methods of Composition – WHAT CLAIMS in the applicants in need to wait for expiration. Initial list all paptent, Applicant need to provide information on each applicant as FREEDOM TO OPERATE in the marketplace, if no agreement in 50 days will be litigated, Phase One litigations

In Attendance, streaming LIVE using Social Media

Aviva Lev-Ari, PhD, RN

The MassBio Annual Meeting focuses on the most critical challenges facing the Massachusetts life sciences industry. The meeting program is designed by a steering committee of industry leaders and the agenda encompasses keynote presentations, panel discussions, interactive working sessions and extensive networking opportunities.

The MassBio Annual Meeting also includes the Innovative Leadership Award Luncheon, which honors an industry leader for his or her contribution to moving the life sciences industry forward.

AGENDA

Day 1

UPDATED on 3/21/2016

John Maraganore to be Honored with Innovative Leadership Award

MassBio is pleased to announce that John Maraganore, Ph.D., CEO of Alnylam Pharmaceuticals will be awarded the 2015 Henri A. Termeer Innovative Leadership Award at MassBio’s 2016 Annual Meeting.

John will accept his award and make keynote remarks at the Awards Luncheon on March 31.

Just Announced!

Tony Coles to give closing keynote at Annual Meeting!

Dr. Coles is a founding investor and the chairman and chief executive officer of Yumanity Therapeutics, a Cambridge, MA-based biotechnology company focused on transforming drug discovery for neurodegenerative diseases caused by protein misfolding such as Alzheimer’s, Parkinson’s and amyotrophic lateral sclerosis (ALS).

Dr. Coles also serves as chairman and chief executive officer of TRATE Enterprises, LLC, a privately held company.

Previously, Dr. Coles was chairman and chief executive officer of Onyx Pharmaceuticals, Inc., which was acquired by Amgen in late 2013. Under his leadership, Onyx introduced two new innovative cancer medicines to patients and established the company’s international presence outside of the U.S. Prior to joining Onyx in 2008, he was president, chief executive officer and a member of the board of directors of NPS Pharmaceuticals, Inc. Before joining NPS Pharmaceuticals in 2005, Dr. Coles was senior vice president of commercial operations at Vertex Pharmaceuticals Inc., and earlier, held a number of executive positions at Bristol-Myers Squibb Company. Additionally, from 1992 until 1996, Dr. Coles held a number of positions of increasing responsibility at Merck & Co., Inc.

Educated at Johns Hopkins University, he earned an M.D. from Duke University and a master’s degree in public health from Harvard University. He completed his cardiology and internal medicine training at Massachusetts General Hospital and was a research fellow at Harvard Medical School.

Dr. Coles currently serves on the board of CRISPR Therapeutics, a biopharmaceutical company focused on developing transformative gene-based medicines for patients with serious diseases He also serves as a member of the board of directors of McKesson Corporation (NYSE: MCK), is vice chair of the board of trustees for Johns Hopkins University and is a member of the board of trustees for Johns Hopkins Medicine. In March 2015, Dr. Coles was named to the National Institutes of Health (NIH) working group tasked with charting the course for President Obama’s Precision Medicine Initiative, now part of the PMI Cohort Program Advisory Panel. Dr. Coles also serves as a member of the council for the Smithsonian’s National Museum of African American History and Culture in Washington, D.C.; a member of the board of trustees for The Metropolitan Museum of Art in New York City; and a member of the Council on Foreign Relations, an independent, nonpartisan membership organization, think tank, and publisher.

Governor Charlie Baker to make opening remarks at the Annual Meeting!

Since taking office in January, 2015, Governor Charlie Baker has been making Massachusetts a great place to live, work, start a business and raise a family while delivering a customer service oriented state government that is as thrifty, creative and hard working as the people of Massachusetts.Governor Baker called on an expert, bipartisan team of Republicans, Democrats and Independents to lead his cabinet.

Together, they are fulfilling his commitment to building stronger and safer communities for our children and families; keeping our roads and bridges safe and reliable; protecting our natural resources; and ensuring our schools and students are successful and safe.

From resolve in the face of unprecedented snow and freezing temperatures, to working to fix the MBTA, the Department of Children and Families, the Health Connector and Registry of Motor Vehicles, to balancing budgets despite billions in deficits all without raising taxes – the Baker Political Administration is making state government truly work for the people of Massachusetts.

Three-day Course by UC San Diego’s Rady School of Management Center for Executive Development: Biotech Demystified: The Science Behind Business

This 3-day hands-on educational program on September 14, 15 & 16, 2015 offered by UC San Diego’s Rady School of Management Center for Executive Development is designed specifically for non-scientist business professionals in the Biotech, Pharma and Life Science industries. It provides participants with a practical understanding of the basic science powering their businesses, giving them the essential tools needed to succeed in today’s life science industries. It provides executives, investors and decision makers with a practical understanding of the basic science powering the biotechnology and pharmaceutical industries.

San Diego is one of the nation’s top-ranking biotech centers and is home to more than 500 biotech and four major research institutions. Biotech Demystified is offered through the Rady School of Management Center for Executive Development in collaboration with UC San Diego’s Division of Biological Sciences and Skaggs School of Pharmacy and Pharmaceutical Sciences.

Led by a rich collection of biomedical research faculty from UC San Diego, attendees will dive into a deep pool of contemporary bioscience that include the following topics:

The following content is a series of discussions that identify innovation in therapeutics and individuals who are leaders in pharmaceutical innovation.

11.5.1 Carmen Drahl. A Great Organic Chemist and Science Writer

Her eyes fit a stellar career path. She is a talent in organic and medicinal chemistry, and an informed reporter.

Extract from Dr. Anthony Melvin Castro, Organic Chemistry

Carmen Drahl

CARMEN DRAHL

Award-winning science communicator and social media power user based in Washington, DC.

Carmen Drahl is a multimedia science journalist and chemistry communicator based in Washington, DC.

ScienceAlum

A social media evangelist, Carmen started her first chemistry blog in 2006. Today, she regularly leverages Twitter, Facebook, and Google Plus Hangouts in her reporting.

Carmen has written about how life may have originated on Earth, explained how new medications get their names, and covered the ongoing issues plaguing the forensic science community. Her video on the food science behind 3D printed cocktail garnishes won the 2014 Folio Eddie Award for Best Association Video.

Until December 2014, Carmen worked at Chemical & Engineering News magazine. Her work has also been featured at Scientific American’s blog network, SiriusXM’s Doctor Radio, and elsewhere.

Carmen holds a Ph.D. in chemistry from Princeton University.

Ph.D. with Erik J. Sorensen. She was on a team that completed the first total synthesis of abyssomicin C, a molecule found in small quantities in nature that showed hints of promise as a potential antibiotic. I constructed molecular probes from abyssomicin for proteomics studies of its biological activity.

M.A. with George L. McLendon worked toward developing a drug conjugate as a potential treatment for cancer. I synthesized a photosensitizer dye-peptide conjugate for targeting the cell death pathway called apoptosis.

Jacobus Fellowship Recipients – Carmen Drahl – Princeton

Jacobus Fellowship Recipients – Carmen Drahl – Princeton

At a reception before the Alumni Day luncheon, President Tilghman (third from left) congratulated the winners of the University’s highest awards for students: (from left) Pyne Prize winners Lester Mackey and Alisha Holland; and Jacobus Fellowship recipients Sarah Pourciau, Egemen Kolemen and Carmen Drahl.

By the time I discovered science blogs I knew my career goals were changing. I’d already been lucky enough to audit a science writing course at Princeton taught by Mike Lemonick from TIME, and thought that maybe science writing was a good choice for me. After reading chemistry blogs for a while I realized “Hey, I can do this!” and started my own blog, She Blinded Me with Science, in July 2006. It was the typical grad student blog, a mix of posts about papers I liked and life in the lab.

Carmen Drahl

At C&E News I’ve contributed to its C&ENtral Science blog, which premiered in spring 2008. I’ve experimented with a few different kinds of posts- observations and on-the-street interviews when

I run into something chemistry-related in DC, in-depth posts from meetings, and video demos of iPod apps. One of my favorite things to do is toy with new audio/video/etc technology for the blog.

Meant to treat: tumors with loss-of-function in the tumor suppressor protein PTEN (phosphatase and tensin homolog)- 2nd most inactivated tumor suppressor after p53- cancers where this is often the case include prostate and endometrial

Mode of action: inhibitor of phosphoinositide 3-kinase-beta (PI3K-beta). Several lines of evidence suggest that proliferation in certain PTEN-deficient tumor cell lines is driven primarily by PI3K-beta.

Medicinal chemistry tidbits: The GSK team seemed boxed in because in 3 out of 4 animals used in preclinical testing, promising drug candidates had high clearance. It turned out that a carbonyl group that they thought was critical for interacting with the back pocket of the PI3K-beta enzyme wasn’t so critical after all. When they realized they could replace the carbonyl with a variety of functional groups, GSK2636771 eventually emerged. GSK2636771B (shown)

Currently working with GLENMARK GENERICS LTD research centre as Principal Scientist, process research (bulk actives) at Mahape ,Navi Mumbai,and leading a team of scientists in developing APIs for regulated markets, this involves visualization and execution of novel routes, polymorphs, and developing intellectual property to protect the invention. This involves all aspects of synthesis in lab and commercialization on plant , support for DMF filing.

Currently involved in development of several targets for regulated markets. Provide support to US/European marketing team for developing and execution of new projects

Process Development :-

Providing guidance and support for process development for challenging of patents in regulated market.

1) Extensive range of chemistry and scale of manufacture from laboratory, scale up laboratory, pilot plant, plant scale including third party activity.

Applied intellectual and synthetic skills to the process development of pharmaceutical drugs/their intermediates, and natural products, neutraceuticals, mettalocenes, speciality chemicals, flavours and fragrances in the laboratory and monitor them during plant trials.

Act as a technology transfer man and provide all data required for transfer from lab to commercialization.

Use of Internet and manual literature search methods to decide on non-infringing route

Write DHR for API before implementation of novel route in the plant and assist for all batches for the DMF purposes, very well versed with IPR issues

Currently working as principal scientist and leading a team of scientists in developing APIs for regulated markets, this involves novel routes, polymorphs, and developing intellectual property to protect the invention. This involves all aspects of synthesis and commercialization and assist in providing support for DMF filing.

11.5.3Amgen files ‘breakthrough’ leukemia drug in the US

Daily News | Sept 22, 2014

Selina Mckee

Biotechnology giant Amgen has filed its investigational cancer immunotherapy blinatumomab in the US for the treatment of certain forms of acute lymphoblastic leukaemia (ALL).

Blinatumomab is the first of Amgen’s BiTE antibody constructs, a novel immunotherapy approach under which antibodies are modified to engage two different targets simultaneously. The drug has already been awarded both ‘Orphan’ and ‘Breakthrough’ status by the Food and Drug Administration, indicating that it could offer a significant advance over available therapies on at least one clinically significant endpoint.

The submission includes data from a Phase II which successfully met its primary endpoint, showing a complete response (no leukaemia cells detectable with microscopy) rate of 43% in patients with relapsed/refractory ALL, including those with resistance to previous treatment approaches.

“Currently, there is no broadly accepted standard treatment regimen for adult patients with relapsed or refractory ALL,” noted Anthony Stein, clinical professor, Haematology/Oncology at City of Hope, adding that “blinatumomab has the potential to significantly advance treatment options for patients living with this difficult-to-treat disease”.

In the US, it is estimated that more than 6,000 cases of ALL will be diagnosed in 2014. In adult patients with relapsed or refractory ALL, median overall survival is just three to five months, further highlighting the urgent need for new treatment options.

High doses of the herb American ginseng (Panax quinquefolius) over two months reduced cancer-related fatigue in patients more effectively than a placebo, a Mayo Clinic-led study found. Sixty percent of patients studied had breast cancer. The findings are being presented at the American Society of Clinical Oncology’s annual meeting.

Researchers studied 340 patients who had completed cancer treatment or were being treated for cancer at one of 40 community medical centers. Each day, participants received a placebo or 2,000 milligrams of ginseng administered in capsules containing pure, ground American ginseng root.

“Off-the-shelf ginseng is sometimes processed using ethanol, which can give it estrogen-like properties that may be harmful to breast cancer patients,” says researcher Debra Barton, Ph.D., of the Mayo Clinic Cancer Center.

At four weeks, the pure ginseng provided only a slight improvement in fatigue symptoms. However, at eight weeks, ginseng offered cancer patients significant improvement in general exhaustion — feelings of being “pooped,” “worn out,” “fatigued,” “sluggish,” “run-down,” or “tired” — compared to the placebo group.

Royal jelly is a honey bee secretion that is used in the nutrition of larvae, as well as adult queens.[1] It is secreted from the glands in the hypopharynx of worker bees, and fed to all larvae in the colony, regardless of sex or caste.[2]

When worker bees decide to make a new queen, because the old one is either weakening or dead, they choose several small larvae and feed them with copious amounts of royal jelly in specially constructed queen cells. This type of feeding triggers the development of queen morphology, including the fully developed ovaries needed to lay eggs.[3]

Other Common Names: Apilak, Gelée Royale, Queen Bee Jelly

Royal Jelly has been called the “Crown Jewel” of the beehive that has become extremely popular since the 1950s as a wonderful source of energy and natural way to increase stamina; perhaps that is the reason why the Queen Bee is so strong and enduring. It is also thought to be a great nutritional source of enzymes, proteins, sugars and amino acids, but there is no scientific proof to verify the supplement’s efficacy for its use as an overall health tonic.

Royal Jelly is a thick, milky material that is secreted from the hypopharyngea- salivary glands in the heads of the young nurse bees between the sixth and twelfth days of life, and when honey and pollen are combined and refined within the nurse bee, Royal Jelly is naturally created. While all larvæ in a colony are fed Royal Jelly, it is the only food that is fed to the Queen Bee throughout her life; other adult bees do not consume it at all. All female eggs may produce a Queen Bee, but this occurs only when – during the whole development of the larvæ – she is cared for and fed by this material – in large quantities.

As a result of this special nutrition, the Queen develops reproductive organs (while the worker bee develops traits that relate only to work, i.e., stronger mandibles, brood food, wax glands and pollen baskets). The Queen develops in about fifteen days, while the workers require twenty-one; and finally, the Queen endures for several years, while workers survive only a few months. “10-2 HDA,” thought to be the principle active substance in Royal Jelly, makes the Queen Bee fifty percent larger than the other female worker bees and gives her incredible stamina, ovulation ability and longevity, living four to five years longer than worker bees who only live forty or more days. Perhaps this is the reason why so many positive qualities have been attributed to Royal Jelly as a truly rare gift of nature, but it should be noted that there is no clinical evidence to support the claims.

There is even great controversy as to the constituents included in the supplement. Most researchers claim that it includes all the B-vitamins and vitamins A, C, D and E; some disagree. It does contain proteins, sugars, lipids (essential fatty acids), many essential amino acids, collagen, lecithin, enzymes and minerals, in addition to the very valuable 10-2-HDA (10-Hydroxy-2-Decenoic Acid). It is said that Royal Jelly may be most effective when combined with honey.

The 10-Hydroxy-2-Decenoic Acid (10-2-HDA) content in Royal Jelly, is said to possess strong inhibition of malignant cell growth, namely transferable AKR leukemia, TA3 breast malignancy, etc., and recent studies indicated immuno-regulation and anti-malignancy activities. It can promote the growth of T-lymphocyte subsets, Interleukin-2 and the generation of tumor necrosis factor. Much research is being conducted on this valuable active constituent, which has exhibited positive physiological and pharmacological effects including vasodilative and hypotensive activities, antihypercholesterolemic activity and anti-inflammatory functions.

This paper reports proof of concept, development, and trials for a novel plastic microcapillary flow disc (MFD) reactor. The MFD was constructed from a flexible, plastic microcapillary film (MCF), comprising parallel capillary channels with diameters in the range of 80−250 μm. MCFs were wound into spirals and heat treated to form solid discs, which were then capable of carrying out continuous flow reactions at elevated temperatures and pressures and with a controlled residence time. Three reaction schemes were conducted in the system, namely the synthesis of oxazoles, the formation of an allyl-ether, and a Diels−Alder reaction. Reaction scales of up to four kilograms per day could be achieved. The potential benefits of the MFD technology are compared against those of other reactor geometries including both conventional lab-scale and other microscale devices.

She was born on the China-Russian border, near the end of the rail line. When they came to US her mother saw bagels and said, look – they have round bread.

At the meetings she always took us to the best Chinese restaurant, and said not to ask what’s in the food. They always brought out a fish fresh from the tank and showed it to us. When she went to Roche, where she became a legend. she got a house on the lake. They had to remove the roof to put a round banquet table in her house. At a meeting in Mexico, we saw the amazing too good to be true Monarch butterflies filling the trees. Her photographic skills are suberb. She’ll live to 100.

Carl Garber just retired and gave me the address. I just found your photo calender!

Yes, I have been hiding in Taiwan for the past almost 10 years. I moved from diagnostic to pharma and selling mostly biosimilar products to pharmaceutical emerging countries which has strong market growth comparing to US/EU.

Abstract: The accurate detection and characterization of cancerous tissue is still a major problem for the clinical management of individual cancer patients and for monitoring their response to therapy. MRI with hyperpolarized agents is a promising technique for cancer characterization because it can non-invasively provide a local assessment of the tissue metabolic profile. In this work, we measured the kinetics of hyperpolarized [1-13C] pyruvate and 13C-urea in prostate and liver tumor models using a compressed sensing dynamic MRSI method. A kinetic model fitting method was developed that incorporated arbitrary RF flip angle excitation and measured a pyruvate to lactate conversion rate, Kpl, of 0.050 and 0.052 (1/s) in prostate and liver tumors, respectively, which was significantly higher than Kpl in healthy tissues [Kpl =0.028 (1/s), P<0.001]. Kpl was highly correlated to the total lactate to total pyruvate signal ratio (correlation coefficient =0.95). We additionally characterized the total pyruvate and urea perfusion, as in cancerous tissue there is both existing vasculature and neovascularization as different kinds of lesions surpass the normal blood supply, including small circulation disturbance in some of the abnormal vessels. A significantly higher perfusion of pyruvate (accounting for conversion to lactate and alanine) relative to urea perfusion was seen in cancerous tissues (liver cancer and prostate cancer) compared to healthy tissues (P<0.001), presumably due to high pyruvate uptake in tumors. Keywords: Hyperpolarized carbon-13; metabolic imaging; cancer; perfusion; kinetic modeling; dynamic MRSI

Hyperpolarization is the nuclear spin polarization of a material far beyond thermal equilibrium conditions. The accurate and correct diagnosis and characterization of cancer is still a major problem for the clinical management of every kind of cancer patients, including individual prostate or liver cancer patients, and also in order to monitor their response to therapy (1-3). Magnetic resonance spectroscopic imaging (MRSI) with hyperpolarized 13C labeled substrates is a new method to study any cancers that may be able to simultaneously and noninvasively assess changes in metabolic intermediates from multiple biochemical pathways of interest. Recent studies have shown a large amount of potential applications of hyperpolarized (HP) 13C MRSI for the in vivo monitoring of cellular metabolism and the characterization of disease. The low natural abundance and sensitivity of 13C compared to protons poses a technical challenge using conventional approaches (4,5). Dynamic nuclear polarization (DNP) of 13C labeled pyruvate and subsequent rapid dissolution generates a contrast agent with a four order-of-magnitude sensitivity enhancement that is injected and gives the ability to monitor the spatial distribution of pyruvate and its conversion to lactate, alanine, and bicarbonate. The conversion of pyruvate to lactate catalyzed by the enzyme lactate dehydrogenase is of particular interest, as the kinetics of this process have been shown to be sensitive to the presence and severity of disease in preclinical models (6,7). HP MRSI can also be used to measure perfusion that in cancer can reflect spatially heterogeneous changes to existing vasculature and neovascularization as tumors surpass the normal blood supply, including microcirculatory disturbance in abnormal vessels. Tumor perfusion data in addition to the metabolic data available from spectroscopic imaging of 13C pyruvate would be of important value in exploring the complex relationship between perfusion and metabolism in cancer at both preclinical and clinical research levels (8-11). The primary purpose of this research was to study the dynamics of simultaneously injected HP [1-13C]-pyruvate and 13C-urea to provide improved characterization of cancerous tissues. To achieve rapid, 2 s temporal resolution, whole mouse MRSI we used a 18-fold accelerated compressed sensing acquisition and reconstruction with smaller flip angles for pyruvate and urea compared to lactate and alanine for efficient usage of the hyperpolarized magnetization by preserving the substrate. This flip angle scheme required using a modified kinetic model that accounts for arbitrary RF flip angles (12-15). Data was acquired in mice with prostate and liver cancer and comparisons were made to normal tissues such as kidney and healthy liver of the metabolite concentrations, including Urea, Pyruvate, and Lactate, the conversion constant (Kpl) between pyruvate to lactate, and the conversion constant (Kpa) between pyruvate to alanine. We also created novel parameterizations of the total pyruvate and urea perfusions in order to assess vascular delivery and tissue uptake. A key new feature of our modeling is the ability to detect metabolic conversion, magnetization exchange between compounds, and perfusion when using arbitrary RF flip angles for different compounds.

We observed a strong correlation between Kpl and the total lactate to total pyruvate ratio, as others have also shown. The ratio is a simpler calculation and easier to implement than the kinetic modeling. However, we have determined through simulation that the total lactate to total pyruvate ratio is highly influenced by the delivery time of pyruvate, so care should be taken when using this ratio if variable vascular delivery rates are expected. Both the kinetic modeling and metabolite ratio are highly influenced by the actual RF flip angles, and precise B1 calibration is important for quantitative measurements. Measurement of urea perfusion can be a marker vascular delivery since urea primarily stays in the vasculature. Liver is a very vascular organ and the opened capillary shape of liver vasculature likely caused high urea perfusion in liver. The kidneys are highly vascularized and are also responsible for concentrating urea for removal in the urine. In tumors, the tissue request for blood is high but in a more uncontrolled way because of the abnormality of blood vasculature and circulation inside most tumors. Thus the urea perfusion in tumors is likely more sporadic and random. Urea cannot perfuse well in some parts of tumor particularly in suspected necrotic regions. On the other hand, some parts of tumor have more metabolic activity and, therefore, these parts need more blood and more vessels, and consequently should have more urea perfusion. Our total pyruvate and urea perfusion parameterizations are different from conventional perfusion modeling, and were designed as a simple representation of the total amount of these compounds that are present in the tissue. In particular, the total pyruvate perfusion also includes any pyruvate or metabolic products that remain in the tissue, in addition to those present in the vasculature. The urea perfusion should primarily represent the vasculature delivery since it primarily stays in the vessels, while the total pyruvate perfusion can also be a marker for vascular delivery but also includes tissue uptake. We hypothesize that when the pyruvate perfusion is higher relative to urea perfusion it represents a higher amount of uptake of the pyruvate that is flowing into the tissue.

Conclusions In this study we fit metabolite T1 values, conversion rates, Kpa, and Kpl, and measured novel pyruvate and urea perfusion parameterizations across cancerous and normal tissues from data acquired with a multiband RF excitation, compressed sensing dynamic MRSI pulse sequence. Our modeling allowed for use of arbitrary RF flip angles between metabolites, which in turn allows for efficient usage of the hyperpolarized magnetization. We observed a high correlation between our Kpl fits and the total lactate to pyruvate signal ratio, suggesting either could be used to characterize pyruvate-lactate metabolism. Through the novel pyruvate and urea perfusion parameterizations we were able to quantify the increased uptake of pyruvate in cancerous tissues, which correlated with increased metabolic conversion to lactate. These provided a more complete characterization of cancerous tissue metabolism and perfusion.

11.5.9 ZSTK474

(Dr. Anthony Melvin Castro)

zstk474

ZSTK474 is a cell permeable and reversible P13K inhibitor with an IC₅₀ at 6nm. It was identified as part of a screening library, selected for its ability to block tumor cell growth. ZSTK474 has shown strong antitumor activities against human cancer xenographs when administered orally to mice without a significant toxic effect.

Phosphatidylinositol 3-kinase (PI3K) has been implicated in a variety of diseases including cancer. A number of PI3K inhibitors have recently been developed for use in cancer therapy. ZSTK474 is a highly promising antitumor agent targeting PI3K. We previously reported that ZSTK474 showed potent inhibition against four class I PI3K isoforms but not against 140 protein kinases.

However, whether ZSTK474 inhibits DNA-dependent protein kinase (DNA-PK), which is structurally similar to PI3K, remains unknown. To investigate the inhibition of DNA-PK, we developed a new DNA-PK assay method using Kinase-Glo. The inhibition activity of ZSTK474 against DNA-PK was determined, and shown to be far weaker compared with that observed against PI3K. The inhibition selectivity of ZSTK474 for PI3K over DNA-PK was significantly higher than other PI3K inhibitors, namely NVP-BEZ235, PI-103 and LY294002.

Medical researchers at the Johns Hopkins Kimmel Cancer Center have published a report that appeared in the journal Science Translational Medicine in which they describe, for the first time, the safe use of a patient’s own immune cells to treat the white blood cell cancer multiple myeloma. There are more than 20,000 new cases of multiple myeloma and more than 10,000 deaths each year in United States. It is the second most common cancer originating in the blood.

The procedure under investigation in this study is called utilizes a specific type of tumor-targeting T cells, known as marrow-infiltrating lymphocytes (MILs). “What we learned in this small trial is that large numbers of activated MILs can selectively target and kill myeloma cells,” says Johns Hopkins immunologist Ivan Borrello, M.D., who led the clinical trial.

According to Borrello, MILs are the foot soldiers of the immune system that attack invading bacteria or viruses. Unfortunately, they are typically inactive and too few in number to have a measurable effect on cancers.

Experiments conducted is Borrello’s laboratory and in the laboratory of competing and collaborating scientists have shown that when myeloma cells are exposed to activated MILs in culture, these cells could not only selectively target the tumor cells, but they could also effectively destroy them.

To move this procedure from the laboratory into the clinic, Borrello and his collaborators enrolled 25 patients with newly diagnosed or relapsed multiple myeloma. Only 22 were able to receive this new treatment, however.

The Hopkins team extracted and purified MILs from the bone marrow of each patient and grew them in the laboratory to increase their numbers. Then they activated the MILs by exposing them to microscopic beads coated with immune activating antibodies. These antibodies bind to specific cell surface proteins on the MILs that induce profound changes in the cells. This induction step wakes the MILs up and readies them to sniff out tumor cells. These laboratory-manipulated MILs were then intravenously injected back into each patient (each of the 22 patients with their own cells). Three days before these injections of expanded MILs, all patients received high doses of chemotherapy and a stem cell transplant, which are standard treatments for multiple myeloma.

One year after receiving the MILs therapy, 13 of the 22 patients had at least a partial response to the therapy (their cancers had shrunk by at least 50 percent) Seven patients experienced at least a 90 percent reduction in tumor cell volume and lived and average of 25.1 months without cancer progression. The remaining 15 patients had an average of 11.8 progression-free months following their MIL therapy. None of the participants experienced serious side effects from the MIL therapy.

According to Borrello, several U.S. cancer centers have conducted similar experimental treatments (adoptive T cell therapy). However, only this Johns Hopkins team has used MILs. Other types of tumor-infiltrating cells can be used for such treatments, but Borrello noted that these cells are usually less plentiful in patients’ tumors and may not grow as well outside the body.

In nonblood-based tumors, such as melanoma, only about half of those patients have T cells in their tumors that can be harvested, and only about one-half of those harvested cells can be grown. “Typically, immune cells from solid tumors, called tumor-infiltrating lymphocytes, can be harvested and grown in only about 25 percent of patients who could potentially be eligible for the therapy. But in our clinical trial, we were able to harvest and grow MILs from all 22 patients,” says Kimberly Noonan, Ph.D., a research associate at the Johns Hopkins Universithttp://www.fiercevaccines.com/special-reports/gvax-pancreasy School of Medicine.

This small trial helped Noonan and her colleagues learn more about which patients may benefit from MILs therapy. As an example, they were able to determine how many of the MILs grown in the lab were specifically targeted to the patient’s tumor and whether they continued to target the tumor after being infused. They also found that patients whose bone marrow before treatment contained a high number of certain immune cells, known as central memory cells, also had better response to MILs therapy. Patients who began treatment with signs of an overactive immune response did not respond as well.

Noonan says the research team has used these data to guide two other ongoing MILs clinical trials. Those studies, she says, are trying to extend anti-tumor response and tumor specificity by combining the MILs transplant with a Johns Hopkins-developed cancer vaccine called GVAX and the myeloma druglenalidomide, which stimulates T cell responses.

These trials also have elucidated new ways to grow the MILs. “In most of these trials, you see that the more cells you get, the better response you get in patients. Learning how to improve cell growth may therefore improve the therapy,” says Noonan.

Kimmel Cancer Center scientists are also developing MILs treatments to address solid tumors such as lung, esophageal and gastric cancers, as well as the pediatric cancers neuroblastoma and Ewing’s sarcoma.